PSYCHOLOGICAL ASPECTS OF THE REHABILITATION OF MOVEMENT CONTROL IN STROKE PATIENTS

Abstract

Psychological models of motor control, although often developed by work with people who have specific pathologies, have been contained very much within the academic sphere of psychology. Physiotherapy and methods of movement rehabilitation have also been developed within the bounds of one profession. With the increasing trend towards working in multidisciplinary settings the opportunity now exists more readily to cross professional boundaries and integrate these two separate knowledge bases in order that better rehabilitation programmes can be developed and in recent years this has begun to happen. With this in mind the research reported here set out to investigate the motor function of stroke patients who have reached a plateau of motor recovery, using dual task methodology. Two experiments were conducted, one involving the "automatic" movement of walking and the other more controlled hand and finger movements. In addition to information about movement it was hoped to investigate whether there was evidence for more than one central information processing system. The results of the walking experiment were inconclusive because of a number of methodological issues which are discussed. The results of the second experiment indicate that there may be evidence for more than one central information processing system. They also showed that in a dual task situation stroke patients differentially allocate their cognitive resources in favour of the movement task. These results are interpreted in terms of stroke patients monitoring their movement more closely. The, results are discussed in terms of a psychological framework of movement control, and issues are raised about whether physiotherapists could make use of this type of approach in developing movement rehabilitation programmes for stroke patients.